By Peter R. Breggin, M.D.
Parents throughout the country are pressured and coerced by schools to give psychiatric drugs to their children. Teachers, school psychologists, and administrators commonly make dire threats about their inability to teach children without medicating them. They sometimes suggest that only medication can stave off a bleak future of delinquency and occupational failure. They even call child protective services to investigate parents for child neglect and they sometimes testify against parents in court. Often the schools recommend particular physicians who favor the use of stimulant drugs to control behavior. These stimulant drugs include methylphenidate (Ritalin, Concerta, and Metadate) or forms of amphetamine (Dexedrine and Adderall).
Stimulant drugs, including methylphenidate and amphetamine, were first approved for the control of behavior in children during the mid-1950s.
Since the early 1990s, North America has turned to psychoactive drugs in unprecedented numbers for the control of children.
In November 1999, the U.S. Drug Enforcement Administration (DEA) warned about a record six-fold increase in Ritalin production between 1990 and 1995. In 1995, the International Narcotics Control Board (INCB), a agency of the World Health Organization, deplored that "10 to 12 percent of all boys between the ages 6 and 14 in the United States have been diagnosed as having ADD and are being treated with methylphenidate [Ritalin]." The United States uses approximately 90% of the world's Ritalin.
The number of children on these drugs has continued to escalate. A recent study in Virginia indicated that up to 20% of white boys in the fifth grade were receiving stimulant drugs during the day from school officials. With 53 million children enrolled in school across the United States, probably more than 5 million are taking stimulant drugs.
Stimulant medications are far more dangerous than most practitioners and published experts seem to realize. Animals and humans cross-addict to methylphenidate, amphetamine and cocaine.
Furthermore, their addiction and abuse potential is based on the capacity of these drugs to drastically and permanently change brain chemistry. Studies of amphetamine show that short-term clinical doses produce brain cell death. Similar studies of methylphenidate show long-lasting and sometimes permanent changes in the biochemistry of the brain.
All stimulants impair growth not only by suppressing appetite but also by disrupting growth hormone production. This poses a threat to every organ of the body, including the brain, during the child's growth. The disruption of neurotransmitter systems adds to this threat.
These drugs also endanger the cardiovascular system and commonly produce many adverse mental effects, including depression. Too often stimulants become gateway drugs to illicit drugs. As noted, the use of prescription stimulants predisposes children to cocaine and nicotine abuse in young adulthood.
Stimulants even more often become gateway drugs to additional psychiatric medications. Stimulant-induced over-stimulation, for example, is often treated with addictive or dangerous sedatives, while stimulant-induced depression is often treated with dangerous, unapproved antidepressants. As the child's emotional control breaks down due to medication effects, mood stabilizers may be added. Eventually, these children end up on four or five psychiatric drugs at once and a diagnosis of bipolar disorder by the age of eight or ten.
In my private practice, children can usually be taken off all psychiatric drugs with great improvement in their psychological life and behavior, provided that the parents or other interested adults are willing to learn new approaches to disciplining and caring for the children. Consultations with the school, a change of teachers or schools, and home schooling can also help to meet the needs of children without resort to medication.
The ADD/ADHD diagnosis was developed specifically for the purpose of justifying the use of drugs to subdue the behaviors of children in the classroom. The content of the diagnosis in the 1994 Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association shows that it is specifically aimed at suppressing unwanted behaviors in the classroom. The diagnosis is divided into three types: hyperactivity, impulsivity, and inattention. Under hyperactivity, the first two (and most powerful) criteria are "often fidgets with hands or feet or squirms in seat" and "often leaves seat in classroom or in other situations in which remaining seated is expected." Clearly, these two "symptoms" are nothing more nor less than the behaviors most likely to cause disruptions in a large, structured classroom.
Under impulsivity, the first criteria is "often blurts out answers before questions have been completed" and under inattention, the first criteria is "often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities." Once again, the diagnosis itself, formulated over several decades, leaves no question concerning its purpose: to redefine disruptive classroom behavior into a disease. The ultimate aim is to justify the use of medication to suppress or control the behaviors.
Advocates of ADHD and stimulant drugs have claimed that ADHD is associated with changes in the brain. In fact, both the NIH Consensus Development Conference (1998) and the American Academy of Pediatrics (2000) report on ADHD have confirmed that there is no known biological basis for ADHD. Any brain abnormalities in these children are almost certainly caused by prior exposure to psychiatric medication.
Hundreds of animal studies and human clinical trials leave no doubt about how the medication works. First, the drugs suppress all spontaneous behavior. In healthy chimpanzees and other animals, this can be measured with precision as a reduction in all spontaneous or self-generated activities. In animals and in humans, this is manifested in a reduction in the following behaviors: (1) exploration and curiosity; (2) socializing, and (3) playing. Second, the drugs increase obsessive-compulsive behaviors, including very limited, overly focused activities.
Children become diagnosed with ADHD when they are in conflict with the expectations or demands of parents and/or teachers. The ADHD diagnosis is simply a list of the behaviors that most commonly cause conflict or disturbance in classrooms, especially those that require a high degree of conformity.
By diagnosing the child with ADHD, blame for the conflict is placed on the child. Instead of examining the context of the child's life – why the child is restless or disobedient in the classroom or home – the problem is attributed to the child's faulty brain. Both the classroom and the family are exempt from criticism or from the need to improve, and instead the child is made the source of the problem.
The medicating of the child then becomes a coercive response to conflict in which the weakest member of the conflict, the child, is drugged into a more compliant or submissive state. The production of drug-induced obsessive-compulsive disorder in the child especially fits the needs for compliance in regard to otherwise boring or distressing schoolwork.
Many observers have concluded that our schools and our families are failing to meet the needs of our children in a variety of ways. Focusing on schools, many teachers feel stressed by classroom conditions and ill-prepared to deal with emotional problems in the children. The classrooms themselves are often too large, there are too few teaching assistants and volunteers to help out, and the instructional materials are often outdated and boring in comparison to the modern technologies that appeal to children.
By diagnosing and drugging our children, we shift blame for the problem from our social institutions and ourselves as adults to the relatively powerless children in our care. We harm our children by failing to identify and to meet their real educational needs for better prepared teachers, more teacher- and child-friendly classrooms, more inspiring curriculum, and more engaging classroom technologies.
At the same time, when we diagnose and drug our children, we avoid facing critical issues about educational reform. In effect, we drug the children who are signaling the need for reform, and force all children into conformity with our bureaucratic systems. Finally, when we diagnose and drug our children, we disempower ourselves as adults. While we may gain momentary relief from guilt by imagining that the fault lies in the brains of our children, ultimately we undermine our ability to make the necessary adult interventions that our children need. We literally become bystanders in the lives of our children. It is time to reclaim our children from this false and suppressive medical approach. I applaud those parents who have the courage to refuse to give stimulants to their children and who, instead, attempt to identify and to meet their genuine needs in the school, home, and community.
Dr. Breggin is the Director of the International Center for the Study of Psychiatry and Psychology. Printed with permission.